Angel Michelle Kellark, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1836 N Humboldt Blvd Apt 2a
Chicago, IL 60647-5033

Phone

(586) 690-5133

NPI assigned

Sep 22, 2023

Last updated

Sep 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chicago Center for Psychotherapy LLC

  • Clinical Social Worker
  • Oak Park, IL
  • NPI 1841589462
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1578342374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 N OAK PARK AVE STE 327",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 N HUMBOLDT BLVD APT 2A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475033",
            "telephone_number": "586-690-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLARK",
        "first_name": "ANGEL",
        "middle_name": "MICHELLE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maeve Catherine Kell
• Michael Edward Kell, R.N, L.C.S.W.
• Kapil Kella, D.D.S.
• Destiny Kellam, MD
• Amelia Suzanne Kellar, MD, MSC, FRCPC
• Aileen Kelleher, LCSW
• Caroline Kelleher, PA
• Gwyneth M Kelleher, PA
• Megan Kelleher, LCSW
• Michael David Kelleher, MD

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.